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Treatment strategy and outcomes in locally advanced head and neck squamous cell carcinoma: a nationwide retrospective cohort study (KCSG HN13-01)

Authors
 Yun-Gyoo Lee  ;  Eun Joo Kang  ;  Bhumsuk Keam  ;  Jin-Hyuk Choi  ;  Jin-Soo Kim  ;  Keon Uk Park  ;  Kyoung Eun Lee  ;  Jung Hye Kwon  ;  Keun-Wook Lee  ;  Min Kyoung Kim  ;  Hee Kyung Ahn  ;  Seong Hoon Shin  ;  Hye Ryun Kim  ;  Sung-Bae Kim  ;  Hwan Jung Yun 
Citation
 BMC CANCER, Vol.20(1) : 813, 2020-08 
Journal Title
BMC CANCER
Issue Date
2020-08
MeSH
Adult ; Aged ; Aged, 80 and over ; Antimetabolites, Antineoplastic / therapeutic use* ; Antineoplastic Agents, Immunological / therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols / therapeutic use* ; Cetuximab / therapeutic use* ; Chemoradiotherapy / methods* ; Cisplatin / therapeutic use* ; Combined Modality Therapy / methods* ; Docetaxel / therapeutic use* ; Female ; Fluorouracil / therapeutic use* ; Follow-Up Studies ; Head and Neck Neoplasms / drug therapy* ; Head and Neck Neoplasms / mortality ; Head and Neck Neoplasms / surgery ; Humans ; Induction Chemotherapy / methods* ; Male ; Middle Aged ; Progression-Free Survival ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck / drug therapy* ; Squamous Cell Carcinoma of Head and Neck / mortality ; Squamous Cell Carcinoma of Head and Neck / surgery ; Survival Rate ; Young Adult
Keywords
Locally advanced head and neck cancer ; Multidisciplinary treatment ; Squamous cell carcinoma ; Strategy
Abstract
Background: By investigating treatment patterns and outcomes in locally advanced head and neck squamous cell carcinoma (LA-HNSCC), we aimed at providing valuable insights into the optimal therapeutic strategy for physicians in real-world practice.

Methods: This is a multi-institutional study enrolled the patients with stage III to IVB LA-HNSCC, except for nasopharyngeal carcinoma, from 2004 to 2015 in thirteen referral hospitals capable of multidisciplinary care.

Results: A total of 445 LA-HNSCC patients were analyzed. The median age was 61 years (range, 24-89). The primary tumor location was the oropharynx in 191 (43%), oral cavity in 106 (24%), hypopharynx in 64 (14%), larynx in 57 (13%) and other sites in 27 (6%). The most common stage was T2 in 172 (39%), and N2 in 245 (55%). Based on treatment intents, 229 (52%) of the patients received definitive concurrent chemoradiotherapy (CCRT) and 187 (42%) underwent surgery. Approximately 158 (36%) of the study population received induction chemotherapy (IC). Taken together, 385 (87%) of the patients underwent combined therapeutic modalities. The regimen for definitive CCRT was weekly cisplatin in 58%, 3-weekly cisplatin in 28% and cetuximab in 3%. The preferred regimen for IC was docetaxel with cisplatin in 49%, and docetaxel, cisplatin plus fluorouracil in 27%. With a median follow-up of 39 months, one-year and two-year survival rates were 89 and 80%, respectively. Overall survival was not significantly different between CCRT and surgery group (p = 0.620).

Conclusions: In patients with LA-HNSCC, the majority of patients received combined therapeutic modalities. Definitive CCRT, IC then definitive CCRT, and surgery followed by adjuvant CCRT or radiotherapy are the preferred multidisciplinary strategies in real-world practice.
Files in This Item:
T202007236.pdf Download
DOI
10.1186/s12885-020-07297-z
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/183920
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